Volume 2

Reports of the Royal Commission appointed to inquire into the subject of Vaccination; with minutes of evidence and appendices / Vaccination Commission.

  • Great Britain. Royal Commission on Vaccination.
Date:
1889-1897
Catalogue details

Licence: Public Domain Mark

Credit: Reports of the Royal Commission appointed to inquire into the subject of Vaccination; with minutes of evidence and appendices / Vaccination Commission. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

    684/798 (page 112)
    [t i.e. Cases 12 and 13; E.M.S. in (iase 21 [series] ; the follomng in Case 139 [series], A.E.L. fNo. 426 in the vaccina- tion register), A.L.C. (No. 408), J.E. (No. 409), W.E.W. (No. 424), J.P.F. (No. 429), F.M.D. (No. 440),N.G.S. (No. 449), A.E. (No. 451), r.J. (No. 453), H.L. (No. 455), E..T.S. (No. 456),P.R. (No. 458), B.J. (No. 439), A.J.L.C. (No. 467), M.M. (No. 469), and L.H. (No. 484); Cases 141, 142,143,144, 145,146, and 180.] [§ In Case 139 [series], namely, A.P., No. 451 in the vaccination register.] [II Case 141.] [II i.e. Cases 11. 102,128 and 129 ; tlie following in Case 140 [series], M.W. (No. 6 of series), C.C. (No. 23) , J.H. (No. 24) , A.N. (No. 25) ,A.J.A. (No. 64), and AV.B. (No. 69); Cases 175 and 187 ; and C.M.J, in Case 227 [series].] [** C.M.J, in Case 227 [series].] Turning now to tlie non-fatal cases investigated by medical men on our bebalf, we bave Had brought to our knowledge with, a view to such investigation 26 J non- fatal cases where syphilis was alleged to have been, or as to some few of the cases possibly to have been, communicated by vaccination. One§ of these 26 cases could not be traced by the medical men whom we asked to investigate it. It had been reported to us, with 21 of the other 25 cases, by a gentleman whose only information as to the case, obtained from a relative of the child's, was that the child had a frightful arm, and broke out badly everywhere, and was a very long time of getting better. The remaining 25 cases were, however, carefully investigated on our behalf, some by Dr. Barlow, some by Dr. Acland, and 15 of them by those gentlemen jointly. In 24 of the 25 there is no evidence that syphilis was communicated by vaccination; indeed, none of the 24 were cases of syphilis at all. In the remaining case|| it appears that there was some ground for the allegation, though it is by no means proved that syphilis was communicated by vaccination, or even that the case was one of syphilis at all. The case, brought to our notice in 1892, was that of a boy born in 1880 and vaccinated in the following year. When examined on our behalf in September 1892 he presented no unmistakable signs of having suffered from syphilis, either inoculated or inherited. The length of time which had elapsed, and the absence of any record, made it impossible to trace the source of lymph. The history of the boy*s illness is extremely uncertain, but upon the whole, if it can be relied upon at all, it tends to render some support to the view that syphilis was communicated by vaccination or by contamination of the vaccination wounds. Besides the non-fatal cases to which we have just referred, there were amongst those investigated by medical men on our behalf, in which non-fatal injury had been alleged or suggested to have been caused by vaccination, 13^ cases in which in the course of the investigation some suspicion of syphilis was raised in connexion with the illness which followed vaccination. In none of these 13 cases, however, is there evidence of any value to show that syphilis was communicated by vaccination ; one*' was a case of inherited syphilis, and the other 12 were not cases of syphilis at all. 430. The evidence offered to us would lead to the belief that whilst with ordinary care the risk of communication of syphilis in the practice of arm-to-arm vaccination can for the most part be avoided, no degree of caution can confer an absolute security. The rejection as vaccinifers of young infants, say below four months of age (in whom con- genital syphilis may be as yet undeclared), and of adults (in whom the disease may possibly have been recently acquired) are precautions which would probably shut out almost the whole of the risk. The outbreaks of syphilis in connexion with vaccination which have been mentioned to the Commission (all of which had been previously published) have occurred chiefly in arm-to-arm vaccination amongst soldiers, or from the use as vaccinifers o£ young infants the offspring of parents whose history was not known to the vaccinator. It must, however, be admitted that neither the examination of the vaccinifer if taken alone, and without a knowledge also of the parents, nor the most scrupulous avoidance of any visible admixture of blood with the lymph, are in them- selves, however valuable, sufficient absolutely to exclude risk. The evidence given by Q. 27,327-9. Dr. Husband, of the Vaccine Institution of Edinburgh, established the fact that all lymph, however pellucid, does really contain blood cells. Absolute freedom from risk of syphilis can be had only when calf-lymph is used, though where the antecedents of the vaccinifer are fully ascertained, and due care is used, the risk may for practical purposes be regarded as absent. 431. As regards the possible effect of vaccination in increasing the prevalence of leprosy, no affirmative e^ddence has been brought before the Commission which in their opinion establishes that this effect has resulted from the practice. On the other hand, much of a strongly negative character has been produced. The evidence which has been supposed to give support to the suspicion that leprosy has been caused by vaccination is of two kinds. First, the recent increase of leprosy in certain districts simultaneously with an increase of vaccination, and secondly , the assertion that in isolated cases leprosy has really followed the practice of vaccination. In regard to the former of these supposed arguments, it has been shown in evidence that there has been no general relationship between the increase of vaccination and the increase of leprosy. Whilst in a few places, of which the Sandwich Islands offer by far the most definite example, leprosy has very largely increased during vaccination periods..; in others, New Zealand, for instance, it has died out, and in others, such as Norway, Iceland, and India, it has probably undergone decline. The evidence of Dr. Beaven Rake, a gentleman of great experience of leprosy as it occurs in the West Indian Islands